Innovate to Ventilate Form

Application for Innovate to Ventilate Form

Collecting information on companies in New York working on COVID-19 solutions

First Name*
Last Name*
Email*
Phone
Please indicate if you have a solution or a problem related to COVID-19*
- I have a product for COVID-19 related issues and need help connecting to government or end users
- I have a product for COVID-19 and need technical assistance with production
- I can offer technical assistance to companies solving COVID-19 issues
- I am an investor who can help fund COVID-19 solutions
- I have a need for a product or service related to COVID-19 (I am a hospital or government)
- I am from government and I am here to help
- I am a manufacturer offering space and production for COVID-19 solutions
- Other
If you selected other, please explain further
Product or service company can produce/offer
Company Name
Company Website
Contact Name at Company
Contact person's email at company
Company phone number
Executive Summary on product or solutions
Recommended by (incubator or innovation professional)
Recommending person's contact email
Recommending person's phone
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